Journal of Addiction Medicine最新文献

{"title":"Financial Well-being and Impact on Alcohol and Mental Health Outcomes During the COVID-19 Pandemic.","authors":"Rishika V Shah, Jeremy W Luk, Melanie L Schwandt, Courtney L Vaughan, Andrew Waters, Nancy Diazgranados, Vijay A Ramchandani, Bethany L Stangl","doi":"10.1097/ADM.0000000000001510","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001510","url":null,"abstract":"<p><strong>Objectives: </strong>The COVID-19 pandemic has had widespread effects on the global economy. The present study seeks to examine the enduring impact of the COVID-19 pandemic on the relationship between financial well-being, alcohol use, and mental health outcomes in individuals with and without an alcohol use disorder (AUD).</p><p><strong>Methods: </strong>Participants who were enrolled in the NIAAA COVID-19 Pandemic Impact on Alcohol Study (C19-PIA) were invited to complete questionnaires on financial well-being, alcohol use, and mental health symptoms as part of an online anniversary survey collected between April 6, 2022, and July 2, 2022. The analytic sample included 250 participants who had valid data on key study variables, including past year AUD previously assessed in the NIAAA Natural History Protocol using structured clinical interviews.</p><p><strong>Results: </strong>Individuals with AUD were less likely to apply for financial assistance and reported greater worries about their financial well-being. Lower financial well-being during the pandemic was associated with higher problematic drinking and worse mental health outcomes. Significant covariates included age, sex, and race.</p><p><strong>Conclusions: </strong>The findings suggest an association between financial stress and problematic alcohol use during financial instability that appeared to persist 2 years into the COVID-19 pandemic. This highlights the potential impact of outreach efforts to improve accessibility of financial assistance, particularly for vulnerable individuals with AUD with financial worries and uncertainties during the pandemic.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study of Patients' Experiences With Collaborative Care for Co-occurring Opioid Use and Mental Health Disorders in Primary Care.","authors":"Grace M Hindmarch, Karen Chan Osilla, Alex R Dopp, Kirsten Becker, Vanessa Miller, Lauren Kelly, Jasen Christensen, Virginia Chitwood-Sedore, Miriam Komaromy, Katherine E Watkins","doi":"10.1097/ADM.0000000000001511","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001511","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals with co-occurring opioid use disorder (OUD) and mental health disorders experience complex treatment trajectories. The collaborative care model (CoCM) is an effective approach for improving behavioral health outcomes in primary care, but has not been tested for patients with co-occurring disorders. We sought to understand patients' experiences receiving CoCM for co-occurring OUD and depression and/or PTSD.</p><p><strong>Methods: </strong>We conducted interviews with patients (N=24) who received CoCM for co-occurring disorders as part of a randomized trial. CoCM was delivered across 18 clinics by 10 care managers who were community health workers embedded into primary care teams. Themes were identified by 2 coders using rapid content analyses.</p><p><strong>Results: </strong>We identified 4 major themes. First, patients hoped CoCM would provide an opportunity to make OUD treatment possible by helping them navigate barriers. Second, patients thought that OUD and mental health disorders were connected and that treatment should be integrated. Third, patients felt that care managers improved their treatment, emphasizing how their compassionate style and commitment facilitated access to and retention in medications for OUD and mental health disorders. Finally, patients reported experiencing barriers to accessing mental health therapy, although support from care managers sometimes helped address those barriers.</p><p><strong>Conclusions: </strong>Patients expressed how care managers facilitated their positive experience with treatment and decreased access barriers common for individuals with co-occurring conditions. Our findings inform how community health workers in the role of care managers can facilitate access to and retention in care for people with co-occurring disorders.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics of Oral and Extended-release Naltrexone in Pregnant and Lactating Individuals and their Infants.","authors":"Nicole Iannella, Jeremiah Momper, Mark Mirochnick, Raymond T Suhandynata, Kelley Saia, Martha Werler, Hendree E Jones, Elisha M Wachman","doi":"10.1097/ADM.0000000000001512","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001512","url":null,"abstract":"<p><strong>Objectives: </strong>Naltrexone may be utilized for the treatment of opioid and/or alcohol use disorder during pregnancy. However, limited information is available on the pharmacokinetics of naltrexone during pregnancy and lactation. The objective of this study was to evaluate maternal and infant concentrations of naltrexone and its major metabolite 6β-naltrexol in relevant matrices across pregnancy and the immediate postpartum period.</p><p><strong>Methods: </strong>Pregnant individuals receiving naltrexone were enrolled in this prospective cohort study. Maternal plasma and urine samples were collected serially during pregnancy at up to 6 time points. At delivery, cord blood, maternal plasma, infant plasma, and infant urine were collected. Four weeks after delivery, breastmilk, maternal plasma, and infant plasma samples were collected. All samples were analyzed for naltrexone and 6β-naltrexol using a validated liquid chromatography tandem mass spectrometry assay.</p><p><strong>Results: </strong>A total of 7 pregnant individuals were enrolled: 4 receiving extended-release and 3 receiving oral naltrexone. Concentrations of naltrexone in maternal plasma in pregnancy remained detectable across the dosing interval for both formulations. The ratio of median cord blood to maternal plasma concentration was 1.11 in the extended-release and 0.74 in the oral group. Of the 7 infants, 1 remained breastfed at 4 weeks. The relative infant naltrexone dose via breastmilk at 31 days after delivery from the 1 infant was 0.83%.</p><p><strong>Conclusions: </strong>While limited due to sample size, these data provide valuable information about the pharmacokinetics of prenatal use of naltrexone and perinatal transfer, guiding counseling and clinical management of the parent-infant dyad.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis Use Disorder Among People With and Without HIV.","authors":"Danielle F Haley, Kaku So-Armah, Amy C Justice, Farah Kidwai-Khan, Ziming Xuan, Rachel Sayko Adams, Matthew P Fox, E Jennifer Edelman, Aleksandra Wrona, Michael J Silverberg, Derek D Satre, Adam Trickey, Suzanne M Ingle, Kathleen A McGinnis","doi":"10.1097/ADM.0000000000001505","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001505","url":null,"abstract":"<p><strong>Objectives: </strong>In the United States, adults aged 65 and older are the fastest-growing age group using cannabis. People living with HIV (PLWH) are an aging population with prevalent cannabis use exceeding the general population. We examined cannabis use disorder (CUD) diagnoses from 2000 to 2022, by age, race/ethnicity, sex, comorbidity, and HIV status.</p><p><strong>Methods: </strong>This analysis (2000-2022) includes electronic health records from 185,372 individuals in the Veterans Aging Cohort Study-HIV, a national US cohort of PLWH matched 1:2 to people without HIV (PLWoH). Annual CUD diagnosis was determined by dividing the number with CUD International Classification of Diseases-Clinical Modification codes by total observations. We examined trends by age, race/ethnicity, sex, comorbidity, and HIV status graphically and with multivariable logistic models.</p><p><strong>Results: </strong>Demographic characteristics were comparable for PLWH (n=58,959) versus PLWoH (n=126,413): 45% Black non-Hispanic (NH); 35% White NH; 7% Hispanic; 3% women, mean age 48 years. Twenty percent of PLWH had a CUD from 2000 to 2022. CUD increased in all subgroups and was consistently higher among PLWH (odds ratio=1.14 [95% CI=1.11-1.18]). Individuals 65 and older experienced the greatest relative increase: PLWH (0.9% vs. 4.0%) and PLWoH (0.03% vs. 3.15%).</p><p><strong>Conclusions: </strong>CUD increased dramatically among all subgroups over time and was higher among PLWH. CUD increase among older PLWH and those with multimorbidity is especially concerning as cannabis interacts with many prescription medications. Universal screening and treatment advances are needed, as is research characterizing patterns and modalities of cannabis use, CUD, and potential harms and benefits in PLWH and PLWoH.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Youth Overdose Prevention Interventions.","authors":"Cala M Renehan, Moriah Wiggins, Radhika Puppala, Avik Chatterjee, Aura Obando, Kathleen R Coleman, Abita Raj, Debra M Schmill, David Flynn, Sarah M Bagley","doi":"10.1097/ADM.0000000000001501","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001501","url":null,"abstract":"<p><strong>Objectives: </strong>Opioid overdose deaths among youth (those 24 y of age and younger) significantly increased in recent years despite a decline in the overall prevalence of substance use. The 2 key objectives of this study were (1) to identify and summarize existing youth overdose prevention interventions and (2) to delineate what is needed to refine, implement, and disseminate this critical information to prevent youth overdose.</p><p><strong>Methods: </strong>Using the adapted PRISMA Checklist for Scoping Reviews, we searched PubMed, Embase, and Web of Science for peer-reviewed descriptions of youth overdose prevention education interventions from 2010 to 2023. We searched US government institutions and news outlets to identify youth overdose prevention interventions in the gray literature. We synthesized key characteristics of programs.</p><p><strong>Results: </strong>We identified a total of 16 unique programs that fit our inclusion criteria, 9 from the peer-reviewed literature and 7 from the gray literature. Half of the studies (n=8) described overdose prevention interventions with some evaluation component that indicated an improvement in overdose prevention knowledge. However, most programs do not have evaluation data available on whether they are effective in reducing opioid overdoses.</p><p><strong>Conclusions: </strong>In this scoping review, we identified a small number of youth-specific overdose prevention interventions. There is an urgent need to develop, implement, and test interventions that address gaps in the youth overdose prevention landscape.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Short Methadone Half-life in the Perinatal Period: A Case Report of a Patient Requiring 900 mg Daily.","authors":"Simone Vais, Brad Shapiro, Scott Steiger","doi":"10.1097/ADM.0000000000001503","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001503","url":null,"abstract":"<p><p>Using serum methadone levels to calculate methadone clearance can help providers individualize dosing, particularly in patients displaying clinical symptoms of rapid clearance, such as peak sedation with concomitant trough withdrawal. Multiple factors may impact methadone dose requirements and serum levels, necessitating deviation from standard methadone titration protocols. The physiologic changes of pregnancy generally shorten methadone's half-life due to CYP450 enzyme induction and increased volume of distribution. Additionally, the emergence of fentanyl-a far more potent opioid than its predecessors-has led to increased opioid tolerance among individuals who use it. As a result, these individuals may require higher methadone doses to effectively manage their opioid dependence. We present a case of a pregnant patient with opioid use disorder, primarily using fentanyl, who presented to labor and delivery at 36 weeks 6 days of gestation. She delivered at 37 weeks 1 day and remained admitted for 4 weeks while undergoing methadone induction. At the time of discharge, she endorsed ongoing opioid withdrawal and required ongoing methadone dose escalation at her outpatient methadone clinic after discharge. Laboratory testing one month postpartum indicated a methadone half-life of 9.22, and she was determined to need thrice daily dosing to maintain therapeutic serum levels, with her total daily dose ultimately reaching 300 mg 3 times daily. In patients who do not respond to standard methadone titration protocols, laboratory testing can support individualized dosing strategies to achieve therapeutic levels while maintaining patient safety.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Individuals Who Elect and Decline Opioid Overdose Education and Naloxone Distribution to Tailor Programs and Expand Impact.","authors":"Michelle L Sisson, Andres Azuero, Elizabeth Hawes, Keith R Chichester, Matthew J Carpenter, Michael S Businelle, Richard C Shelton, Karen L Cropsey","doi":"10.1097/ADM.0000000000001407","DOIUrl":"10.1097/ADM.0000000000001407","url":null,"abstract":"<p><strong>Background: </strong>In response to the opioid epidemic, federal agencies have stressed the importance of targeted naloxone distribution through avenues such as Opioid Overdose Education and Naloxone Distribution (OEND). OEND effectively reduces mortality by training laypersons to respond to overdose situations. Despite demonstrated effectiveness, OEND remains underutilized. This project aimed to characterize those who illicitly use opioids to determine avenues for future tailoring of OEND programs.</p><p><strong>Methods: </strong>Individuals who illicitly used opioids within the past 6 months were recruited via online social media. Participants completed an online questionnaire that assessed history of opioid use and were given the option to receive opioid overdose and naloxone administration training. Those who elected training (n = 111) and those who declined (n = 193) were compared on opioid use, severity of use, and overdose experiences.</p><p><strong>Results: </strong>Participants (N = 304) were 47% male and 83% White. Tests of between group differences with measures of effect size were used for analyses. Those who elected training endorsed greater intravenous administration (χ 2  = 4.18, P  = 0.041, Cramer's V  = 0.12). Individuals who declined training reported more frequent nonprescribed methadone use (χ 2  = 7.51, P  = 0.006, Cramer's V  = 0.16), overdose hospitalizations ( t (298) = 2.13, P  = 0.034, Cohen's d  = 0.26), and observed overdoses ( t (300) = 3.01, P  = 0.003, Cohen's d  = 0.36). After adjusting for multiple comparisons, only the differences in nonprescribed methadone use and observed overdoses remained statistically significant.</p><p><strong>Conclusions: </strong>Individuals who declined training were more likely to report ever use of nonprescribed methadone and having witnessed others overdose. They may have had greater exposure to naloxone, hence decreasing perceived need for training. Understanding characteristics of those who elect and refuse training could inform structuring of programs and recruitment approaches.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"268-273"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Associations of Kratom (Mitragynine), Opioids, Other Substances, and Sociodemographic Variables to Drug Intoxication-related Mortality.","authors":"Armiel A Suriaga, Ruth M Tappen, Christopher R McCurdy, David Newman, Oliver Grundmann, John F Kelly","doi":"10.1097/ADM.0000000000001417","DOIUrl":"10.1097/ADM.0000000000001417","url":null,"abstract":"<p><strong>Introduction: </strong>The US age-adjusted drug overdose rate increased by 298%, with fentanyl being the main contributor to drug overdose deaths. The contribution of kratom to drug overdoses or intoxication is seldom reported despite its increasing use and detection among overdose decedents.</p><p><strong>Methods: </strong>Our cross-sectional study utilized deidentified data from the Florida Department of Law Enforcement, 2020-2021 (N = 30,845). The medical examiners ascertained the exposures of interest (kratom, opioids, and other substances) and the outcome variable of drug intoxication-related mortality (DIRM) through autopsies and toxicology results. DIRM refers to any death from a substance identified as drug toxicity or intoxication. We used regression modeling to examine the association of exposure with DIRM.</p><p><strong>Results: </strong>Five hundred fifty-one cases were confirmed kratom (mitragynine) exposures. More males died of DIRM (81.5%), primarily White (95.1%) and 35-44 years old (40.5%). Among mitragynine exposures, 484 (87.8%) died of DIRM; 36 decedents (6.5%) used kratom as the sole substance, and 515 (93%) used multiple substances; 437 (79.3%) used at least 1 opioid. The odds of dying of DIRM were 7.6 times higher among those mitragynine exposed compared with non-mitragynine exposed (univariate model) and 5.6 times higher after adjusting for confounders (multivariate model) (adjusted odds ratio = 5.6; 95% confidence interval, 4.1-7; P  < 0.001). Opioid use increased the odds of dying of DIRM (adjusted odds ratio = 11.7; 95% confidence interval, 10.9-12.7; P  < 0.001).</p><p><strong>Conclusion: </strong>Our results indicate that dozens of decedents died of kratom (mitragynine) exposures alone, which has safety implications. Co-using opioids with kratom further increased the odds of dying of DIRM, indicating that kratom may not always work as a harm-reduction agent.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"306-313"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Implementation Factors and Policy to Improve the Effectiveness of Naloxone.","authors":"Ashly E Jordan, Mary Brewster, Pamela Mund, Grace Hennessy, Chinazo O Cunningham","doi":"10.1097/ADM.0000000000001406","DOIUrl":"10.1097/ADM.0000000000001406","url":null,"abstract":"<p><p>More than 50 years of high-quality data demonstrate that naloxone is an efficacious and cost-effective overdose reversal agent. Intranasal naloxone is now available in the United States as an over-the-counter and generic medication for the first time since the start of the overdose crisis more than 20 years ago. As the overdose crisis continues to contribute to substantial loss of life, there is an historic opportunity for jurisdictions to expand equitable and sustained access to intranasal naloxone. Further, through simultaneously enacting and expanding effective Naloxone Access and Good Samaritan laws, and equitably implementing these laws, there is the potential to maximize the population-level effectiveness of naloxone to sustainably reduce overdose mortality.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"239-241"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Naltrexone Effective and Safe for Treating Amphetamine-Type Stimulant Use Disorder? A Systematic Review and Meta-analysis.","authors":"Gabriel Bastien, Christina McAnulty, Heidar Sharafi, Amani Mahroug, Laurent Elkrief, Daniela Ziegler, Simon Dubreucq, Louis-Christophe Juteau, Didier Jutras-Aswad","doi":"10.1097/ADM.0000000000001422","DOIUrl":"10.1097/ADM.0000000000001422","url":null,"abstract":"<p><strong>Objectives: </strong>We conducted a systematic review and meta-analysis (PROSPERO ID: CRD42023401796) of randomized placebo-controlled trials evaluating the effectiveness and safety of naltrexone as a standalone pharmacotherapy for amphetamine-type stimulant use disorder (ATSUD).</p><p><strong>Methods: </strong>We searched EMBASE, MEDLINE, EBM Reviews, PsycINFO, CINAHL, Google Scholar, and trial registries on April 11, 2023, and updated on September 24, 2024, to identify randomized placebo-controlled trials evaluating the effectiveness of naltrexone for the treatment of ATSUD. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed for reporting the study. Risk of bias and quality of evidence were assessed with the Cochrane Risk-of-bias Assessment tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Risk ratios (RRs) or Peto odds ratio were estimated for binary outcomes as appropriate. Standardized mean differences were calculated for continuous outcomes.</p><p><strong>Results: </strong>Five studies (n = 419 participants) were eligible. We found no significant difference between naltrexone and placebo for amphetamine-type stimulant use (RR = 0.903, 95% confidence interval [CI] = 0.698 to 1.167, P  = 0.44, I2  = 96.1%; 4 studies), study retention (RR = 1.055, 95% CI = 0.942 to 1.182, P  = 0.35, I2  = 45.0%; 4 studies), end-of-treatment craving (standardized mean difference = 0.069, 95% CI = -0.272 to 0.410, P  = 0.69, I2  = 0.0%; 2 studies), and serious adverse events (odds ratio = 1.086, 95% CI = 0.414 to 2.849, P  = 0.87, I2  = 0.0%; 3 studies). The quality of evidence was low to very low.</p><p><strong>Conclusions: </strong>The available evidence does not support the use of standalone naltrexone to treat ATSUD. Significant research efforts must be put toward to identify effective pharmacotherapies to complement psychosocial interventions for ATSUD.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"322-330"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}